■探讨改良Cretan方案在准分子激光原位角膜磨镶术(LASIK)后扩张(PLE)患者中的临床疗效和安全性。
■在这项回顾性研究中,16例PLE患者的26只眼接受了改良的Cretan方案(联合跨上皮光疗角膜切除术和加速角膜胶原交联)治疗。视觉,屈光,层析成像,并记录术前以及治疗后6,12和24个月的像差结局和点扩散功能(PSF).
■与基线相比,术后24个月未矫正视力和最佳矫正视力均稳定(最小分辨率角度[LogMAR]的对数为0.89±0.36至0.79±0.33,对数为0.31±0.25至0.24±0.19,分别,所有值的p>0.05)。平均K1,K2,Kmean,角膜厚度最薄,基线球差为45.76±5.75D,48.62±6.17D,47.13±5.89D,433.16±56.86μm,和-0.21±0.63μm。这些值降低到42.86±6.34D,45.92±6.74D,44.21±6.4D,391.07±54.76μm,术后24个月为-0.51±0.58μm(分别为p<0.001,p=0.002,p<0.001,p=0.001和p=0.02)。平均球面当量,清单气瓶,Kmax,中央角膜厚度,其他角膜像差(均方根,三叶,昏迷,四叶箔,散光),PSF保持稳定(所有变量p>0.05),而前后抬高在术后24个月显著改善(分别为p<0.001和p=0.02)。随访24个月无手术并发症发生。
■改良的Cretan方案是PLE患者的一种安全有效的治疗选择,可在24个月的随访中提供视觉稳定和地形图参数的显着改善。需要进一步的研究来支持我们的结果。
To investigate the clinical efficacy and safety of the modified Cretan protocol in patients with post-laser in situ keratomileusis ectasia (PLE).
In this retrospective study, 26 eyes of 16 patients with PLE were treated with the modified Cretan protocol (combined transepithelial phototherapeutic keratectomy and accelerated corneal collagen cross-linking). Visual, refractive, tomographic, and aberrometric outcomes and point spread function (PSF) were recorded preoperatively and at 6, 12, and 24 months after treatment.
Both uncorrected and best corrected visual acuity were stable at 24 months postoperatively compared to baseline (from 0.89±0.36 to 0.79±0.33 logarithm of the minimum angle of resolution [LogMAR] and 0.31±0.25 to 0.24±0.19 LogMAR, respectively, p>0.05 for all values). The mean K1, K2, Kmean, thinnest corneal thickness, and spherical aberration at baseline were 45.76±5.75 diopters (D), 48.62±6.17 D, 47.13±5.89 D, 433.16±56.86 μm, and -0.21±0.63 μm respectively. These values were reduced to 42.86±6.34 D, 45.92±6.74 D, 44.21±6.4 D, 391.07±54.76 μm, and -0.51±0.58 μm at 24 months postoperatively (p<0.001, p=0.002, p<0.001, p=0.001, and p=0.02, respectively). The mean spherical equivalent, manifest cylinder, Kmax, central corneal thickness, other corneal aberrations (root mean square, trefoil, coma, quatrefoil, astigmatism), and PSF remained stable (p>0.05 for all variables), while anterior and posterior elevation were significantly improved at 24 months postoperatively (p<0.001 and p=0.02, respectively). No surgical complications occurred during the 24-month follow-up.
The modified Cretan protocol is a safe and effective treatment option for PLE patients that provides visual stabilization and significant improvement in topographic parameters during the 24-month follow-up. Further studies are needed to support our results.